Aetna smokes crack

[DMDubey76 1]

Hey kids! I'm still pre-op. All of my required tests and appointments have been done for over a month now. Now it's called the waiting GAME. Don't get me wrong, I'm thankful my insurance pays 80% - but man, what a run-around.

Initially Aetna rejected the claim stating they needed a 2 year weight history. I called the surgeon's office and they gave me the name of the pre-certification nurse assigned to my claim. I called him myself (although I'm not sure I was supposed to call him directly) and asked if my gyno can fax the weight info (I go to the gyno every year but I rarely go to my primary doctor because thankfully I'm rarely sick). He had said that as long as it was a health care provider the info from her office would be acceptable. Yippee.

A few days later my primary care office called me stating that since I haven't had a physical since 2009 they could not give Aetna any info about me because they didn't have anything recent. Aetna had faxed them a pre-surgery request. I told the office I understood there was no info they could provide to Aetna, however I had been through SO many tests already - tests that they would normally do for a physical anyhow (complete blood work panel, EKG, echocardiogram, etc.), what would a physical possibly have to entail being that I had all that other stuff done already? It irked me because I'm seeing dollar signs and time wasted. I made the physical appointment for 9/16/11 to appease the doctor's office. I then called the surgeon and asked that they contact the pre-certification nurse since he said the info from the gyno would suffice. Well go figure, he was on vacation until 9/12/11.

So, today being the 14th the surgeon's office was trying to contact him again. My frustration is through the roof. Aetna has been telling the surgeon's offce that they had not gotten the fax (which the office said they faxed over more then once). It's 1:30pm Wednesday. I'm waiting on pins and needles to hear back from the surgeon's office, hopefully they'll tell me Aetna said the weight info is fine from my gyno and they don't need anything from my primary doctor. IF that's the case (and I praying it is) I will cancel that silly physical appointment!

Wish me luck guys....I think I'm gonna need it!

[MyBandAID 0]

Sorry for the frustration they are giving you!! Hope it all falls into place and works out for you quickly. Keep calm and carry on

[thatchick_j 7]

I'm still laughing @ aetna on crack

[rn2012 6]

Uh OH, u hv me afraid..I also have Aetna, Aetna *** but IM covered 100%. I hope they dont deny me. I have documentation of my weight over the years, but I hvnt been 270 for 2 years, i actually weighed 225 in 2009, i hope that doesnt hurt me

[BaileyRose 13]

Weird... I have Aetna and had no problems. I expected to be denied the first time... But I wasn't. Once it was submitted to insurance I heard back in., I think, 4 days. Hope everything speeds up for you!

[DMDubey76 1]

HOLY MOLY - I got a call from my surgeon's office this morning. My pre-cert nurse still said he hadn't gotten their fax with my 2 year weight history...BUT, she asked if she could give him the info over the phone and he said "yes"! So I am delighted to say I was APPROVED!!! I'm still reeling!

Next step is the last appointment with the surgeon which may be the week of Sept. 19 or 26.